RESUMEN
The safety and ethical aspects of blood donation are examined in the light of current legislation and practice. The advantages and disadvantages of voluntary and paid donation are looked at in view of recent data concerning risk factors in various potential donor groups. It is concluded that voluntary, non-remunerated blood donation remains the safest and most ethical means of securing the blood supply.
Asunto(s)
Bancos de Sangre , Donantes de Sangre , Síndrome de Inmunodeficiencia Adquirida/sangre , Europa (Continente) , Virus Linfotrópico T Tipo 1 Humano , Virus Linfotrópico T Tipo 2 Humano , Humanos , Cruz RojaRESUMEN
The data from 359 transfusion reactions reported over a 3-year period have been compared with those obtained from 359 matched units given at the same time as the former but not implicated in a reaction. It was found that patients who developed reactions which were not accompanied by a change in body temperature received units with a longer storage time than patients experiencing febrile reactions. In addition it was noted that reactions which included a skin rash also tended to be associated with units stored for longer. In a further prospective assessment plasma histamine levels were measured in a group of 71 patients experiencing 'anaphylactoid', febrile and mixed transfusion reactions as well as in individuals in whom blood transfusions did not cause a reaction. The 'anaphylactoid' reaction group demonstrated a mean plasma histamine level in excess of 1 ng/ml, whereas mean concentrations below 0.50 ng/ml were recorded in the other 3 groups. Our data also suggested that in general, more and 'older' blood was given to the 'anaphylactoid' reactors. The high plasma histamine concentrations could readily contribute to the rash, wheeze and flushing recorded in these individuals. Thus, if a long shelf-life for stored blood is required, strategies which remove histamine from the unit may be worth considering.
Asunto(s)
Conservación de la Sangre , Histamina/sangre , Reacción a la Transfusión , Humanos , Factores de TiempoRESUMEN
Suppression of Lutheran blood group expression is usually associated with an autosomal dominant suppressor gene In(Lu) which results in the rare Lu(a--b--) phenotype. X-linked recessive suppression can also occur under the control of the XS locus with normal (XS1) and suppressor (XS2) alleles. The only known kindred with XS2 segregating was examined for polymorphic DNA markers with known regional localisations on the X chromosome. Two point linkage analysis suggested linkage of XS to DXS14 (p58.1) with theta = 0.00, z = 1.96. DXS14 is situated near the centromere at Xp11. Recombinants with DXS84 (distal to DXS14 on Xp) and recombinants with DXYS1 (pDP34) (on the proximal part of Xq) suggests a localisation for XS near the centromere, between DXS84 and DXYS1 (Xp21.2-Xq21.1). Linkage to a marker on the X chromosome confirms the original assignment of XS to the X chromosome, which was based on pedigree inspection from this family.
Asunto(s)
Ligamiento Genético , Sistema del Grupo Sanguíneo Lutheran/genética , Supresión Genética , Cromosoma X , Bandeo Cromosómico , Femenino , Marcadores Genéticos , Humanos , Masculino , LinajeRESUMEN
Plasma and whole blood histamine levels and white cell counts have been monitored over a 6-week period of storage in standard citrate-phosphate-dextrose supplemented with adenine (CPDA) blood packs, add-back blood packs, and also CPDA and add-back packs which were subjected to a microfiltration process at the time of collection. Our results indicate that the plasma histamine level rises and the white blood count falls progressively with time, the former being most marked after the 3rd week of blood storage. At 6 weeks, there was no significant difference between the plasma and whole blood histamine level, suggesting that the entire complement of histamine in blood was now in plasma. Microfiltration substantially reduced the white cell count in the packs, and this was reflected in a greatly reduced whole blood and (subsequently) plasma histamine concentration.
Asunto(s)
Conservación de la Sangre , Histamina/sangre , Ultrafiltración , HumanosRESUMEN
The family of a male Lu(a-b-) propositus whose red cells showed some characteristics of the dominant and some of the recessive type of Lu(a-b-) phenotype was studied. The investigation revealed a third genetic background for this rare phenotype, an X-borne suppressor recessive in effect. The notation proposed is XS1 for the normal gene and XS2 for the suppressor gene which affects the expression of Lutheran and other antigens.
Asunto(s)
Sistema del Grupo Sanguíneo Lutheran/genética , Femenino , Genes Recesivos , Humanos , Masculino , Linaje , Fenotipo , Supresión Genética , Cromosoma XRESUMEN
A number of demographic, psychological, medical, immunological and haematological indices, as well as sexual practices and partner numbers, were investigated in 97 homosexual men in Adelaide. A comparison of blood donors with non-donors among these men showed that the donors were younger, spent more time in the homosexual subculture, maintained a stable blood-donation pattern, and were significantly less likely to have had a sexually transmitted disease. Donors contacted their sexual partners in non-anonymous settings more frequently than did non-donors.
Asunto(s)
Donantes de Sangre/psicología , Homosexualidad , Adulto , Australia , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
The histamine content in plasma samples obtained from a group of healthy blood donors, from blood stored in citrate-phosphate-dextrose supplemented with adenine (CPDA) packs for up 28 days, and from the side arm of a transfusion line was measured by radio-enzymatic assay. Healthy donors had a mean plasma histamine content of 0.79 ng per ml. Blood stored in CPDA initially showed a similar histamine level (0.69 ng/ml on day 3 of storage), but there was a progressive rise with time, and at 28 days, the level was 20.5 ng per ml. The increase in histamine is best described by a positive exponential and may be explained by a process whereby the plasma histamine level increases the degree of histamine release from blood cells. The histamine levels in the blood infused into patients tended to be higher than those found in the stored units of the same age, if these packs were less than 7 days old. This may have been caused by the unit becoming warmer during transfusion. We speculate that the histamine levels in the older units of stored blood were high enough to cause or augment transfusion reactions and that the storage age of blood may have a bearing on the incidence of transfusion reactions.
Asunto(s)
Conservación de la Sangre , Transfusión Sanguínea , Histamina/sangre , Humanos , Factores de TiempoRESUMEN
Four different subpopulations in South Australia, which were expected to have high rates of hepatitis B infection (Asians, Aboriginals, homosexual men, and drug addicts) were examined for their contribution to the total reservoir of hepatitis B surface antigen (HBsAg) carriers and to the total annual incidence of acute hepatitis B infection in South Australia. Age-specific prevalence data were also examined to assess the ages at which infection is commonly acquired. It was found that the above four groups, which comprise 3% of the State's population, are likely to include about 75% of HBsAg carriers in the State, but contribute a minority of the total new infections each year; they are not likely to present a significant risk of infection to the community at large. Three different age-related patterns of acquisition of infection were recognized--among Southeast Asians and Aboriginals, homosexual men and drug addicts, and the general community, respectively. The above approach, and to some extent the general findings, should be applicable to other similar communities in the formulation of effective policies for the control and prevention of hepatitis B infection.
Asunto(s)
Reservorios de Enfermedades/microbiología , Hepatitis B/epidemiología , Vacunación , Vacunas Virales , Adolescente , Adulto , Factores de Edad , Anciano , Asia/etnología , Australia , Donantes de Sangre , Niño , Preescolar , Femenino , Hepatitis B/inmunología , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B/inmunología , Vacunas contra Hepatitis B , Homosexualidad , Humanos , Lactante , Recién Nacido , Estilo de Vida , Masculino , Persona de Mediana Edad , Nativos de Hawái y Otras Islas del Pacífico , Riesgo , Trastornos Relacionados con Sustancias/complicacionesRESUMEN
The relative safety of homologous blood transfusion is in large part due to constant surveillance by blood bankers and clinicians. Quality control of blood supply and transfusion includes collection, documentation, storage, serological testing, administration and follow-up. The provision of serologically compatible blood requires meticulous monitoring of grouping, screening and crossmatching techniques. A hospital transfusion committee should be an integral part of any quality control programme to ensure effective communication between clinical, laboratory and administrative staff.
Asunto(s)
Conservación de la Sangre/normas , Transfusión Sanguínea/normas , Tipificación y Pruebas Cruzadas Sanguíneas/normas , Humanos , Control de Infecciones , Control de Calidad , Reacción a la TransfusiónRESUMEN
4 Wu-positive donors were found in a total of 16,476 South Australians. Family studies showed Wu to be independent of the Lutheran and P blood group systems. Of six examples of anti-Wu detected in 4,200 blood donors by a Technicon AutoAnalyzer, only two were detectable manually.
Asunto(s)
Antígenos de Grupos Sanguíneos/genética , Frecuencia de los Genes , Australia , Donantes de Sangre , Femenino , Humanos , Isoanticuerpos/genética , Isoantígenos/genética , Masculino , LinajeAsunto(s)
Eritroblastosis Fetal/inmunología , Isoanticuerpos/biosíntesis , Sistema del Grupo Sanguíneo Rh-Hr , Sistema del Grupo Sanguíneo ABO , Incompatibilidad de Grupos Sanguíneos/diagnóstico , Incompatibilidad de Grupos Sanguíneos/terapia , Prueba de Coombs , Eritroblastosis Fetal/etiología , Eritroblastosis Fetal/prevención & control , Eritrocitos/inmunología , Femenino , Humanos , Recién Nacido , Sistema del Grupo Sanguíneo de Kell , Antígenos del Grupo Sanguíneo de Lewis , Sistema del Grupo Sanguíneo MNSs , Intercambio Materno-Fetal , Embarazo , Complicaciones del Embarazo/inmunologíaRESUMEN
A rational approach to the use of blood entails careful assessment of blood loss in the individual patient and a clear awareness of the advantages and disadvantages which may follow the use of whole blood. The use of red cell concentrates in preference to whole blood has therapeutic and immunological advantages for a majority of patients. Predictable changes which follow massive transfusion must be assessed and appropriate steps taken to minimize any undesirable results in the patient. A protocol for emergency transfusion is outlined.
Asunto(s)
Transfusión Sanguínea , Adulto , Anciano , Conservación de la Sangre , Volumen Sanguíneo , Urgencias Médicas , Eritrocitos , Hemorragia/fisiopatología , Humanos , Complicaciones Posoperatorias/fisiopatologíaRESUMEN
A standard counterelectrophoresis method has been used to screen almost 250,000 samples from South Australian and Northern Territory blood donors since 1971. The initial incidence of approximately one hepatitis B antigen positive donor per thousand has diminished as these donors have been excluded from further blood donation. There is a predominance of males in the series, and more of the hepatitis B antigen carriers are in the younger age groups than expected. A higher than expected incidence of hepatitis B antigen positives has been noted in Northern Territory donors. Follow-up of donors found to be hepatitis B antigen positive has shown that the majority remain positive for more than two years without developing overt hepatitis. These individuals may represent a long-term asymptomatic carrier state.
Asunto(s)
Donantes de Sangre , Portador Sano/epidemiología , Antígenos de la Hepatitis B , Hepatitis B/epidemiología , Adolescente , Adulto , Anciano , Australia , Antígenos de Grupos Sanguíneos , Femenino , Estudios de Seguimiento , Hepatitis B/genética , Humanos , Masculino , Persona de Mediana Edad , Mucormicosis/diagnóstico , Factores SexualesRESUMEN
A survey has been made of the results of 12 months' VDRL screening in a blood transfusion service. Positive VDRL tests were found on 318 of the 73 350 blood donations collected during 1974. Thirty-four tests confirming specific treponemal infection were found in 24 donors. A battery of confirmatory tests showed the remaining 284 positive VDRL reactions from 235 donors to be biological false positive (BFP) results, and, of these, one-third were considered entirely negative by the reference laboratory. BFP reactions were commoner in female donors than in males, and a higher incidence than expected was observed in younger female donors and older male donors. A marked seasonal incidence was noted, 65% of all BFP tests from the transfusion service being found in the four colder months of May to August. Although some differences exist between the group as a whole and the 36 donors (15.3%) found to have BFP results on more than one occasion during the year, there is little evidence from these studies to suggest that regular blood donation per se is a contributing factor to the finding of a BFP result in VDRL screening. It is probable that the population tested regularly by the blood transfusion service reflects a small but representative sample of the community as a whole.